Chapter 3 Crisis Intervention - Richard D. Berrett
The phone rings several times before Bishop Cole, with eyes still closed and
senses dulled by sleep, finds it and places the receiver to his ear. Through
muffled sobs, a woman relates the details of an evening of fighting with her
husband: caustic remarks, painful accusations, bitter confrontations—a crisis.
The silence settling on the emergency room brings with it the realization
that the baby is dead. The medical staff did all they could. Still, the baby is
gone. Numbed, the parents stare blankly at the wall. They seem to be in another
world, the world of crisis.
Answering the knock at the door, a youth leader sees an angry teenager
desperate to tell his story: "Mom and Dad just don't understand me. They
won't listen. I hate them!" A crisis.
Each of these situations illustrates the overwhelming nature of a crisis. The
people involved feel helpless because their problems seem to have no solutions—they
lack the necessary resources to cope with their difficulties.
Individuals and families constantly adjust to the demands of life. These
adjustments usually provide people with a sense of security. But when a person
finds adjusting too difficult, he may develop a sense of helplessness and
inability to cope. Crisis intervention includes helping people who are unable to
adjust to the challenges of life to regain the sense of stability and security
that they enjoyed prior to the crisis.
Some people, because of past experiences, are more resilient to the shock of
a crisis and may require little aid. Others who are less experienced and who may
lack the necessary resources often demand immediate help. You can help by
understanding the crisis, by exploring available resources, and by evaluating
possible solutions and their consequences with the person.
Understanding the Crisis
The first help a lay counselor can give is to offer a listening ear and a
comforting voice. As the troubled person expresses his feelings to someone who
is nonjudgmental, calm, interested, empathetic, and helpful, his stress
diminishes, and he gains a more realistic understanding of his crisis. Here is
an example of such a discussion:
Stacie:
Bishop Cole, Jim left about an hour ago, and I know he doesn't
love me anymore. How could he walk out on me and the children?
Bishop: It seems to you that if he really cared he wouldn't have left?
Stacie: Yes, I could have left too; after all, I'm the one who is
rejected, not him.
Bishop: You sound as if you don't think Jim is hurt by what has happened.
Stacie: If it did hurt him, he sure didn't let me know.
Bishop: Could it be that when Jim is really hurt, he becomes angry and
leaves? Maybe his leaving doesn't mean he no longer loves you and the children,
but that he is so frustrated he doesn't know what else to do.
Stacie: I hadn't thought of it that way.
Through listening carefully to Stacie, reflecting her emotions and thoughts
back to her, and asking relevant questions, the bishop helps her understand the
crisis. He helps her distinguish her feelings about the crisis from the actual
nature of the crisis. After all, it is possible that Jim left feeling as much
pain as Stacie and that Stacie's belief that he doesn't love her is incorrect.
When you, the counselor, gain an accurate view of the nature of the crisis,
you become a source of understanding and information for the person you counsel.
The trust you build as you demonstrate concern by listening will influence the
person to listen to your guidance. He will become more willing to explore all
parts and implications of the crisis and to receive your counsel. You should
clarify, give perspective, and define the crisis so that the sufferer's anxiety
is reduced and his hope is rekindled.
Avoid simple prescriptions. If you give simple prescriptions without really
listening to the person, he will become defensive and may reject your
recommendations. Your effectiveness as a counselor is based on your ability to
demonstrate understanding and concern.
It is important in a crisis to assess the person's stability. Because the
crisis may leave him helpless and hopeless, he may consider suicide. It is wise
to discuss with the person whether he has suicidal thoughts. Facing such
thoughts head-on can prevent a suicide. Similarly, finding out whether the
distressed person has violent feelings toward others may keep him from harming
someone else. If the danger is great enough that your discussion does not
decrease his hatred and rage, it may be essential to seek professional aid.
Discussing several questions with those going through a crisis can help them
understand the crisis. You might ask: What caused the crisis? How are others
being affected by the experience? Has this type of thing occurred before? How
long has this been happening? Who else knows about the trouble?
After the troubled person and the counselor understand the crisis, the second
phase of crisis intervention may begin.
Using Appropriate Resources
Because of the urgency of a crisis, it is generally necessary to give
immediate help to alleviate it. Several sources of help are available, and it is
important for the counselor to use each one that is appropriate. These sources
are discussed below:
Spiritual Strength
Religious beliefs provide an eternal perspective for many of life's
tragedies. The counselor can help people explore the broad meanings of
discouraging experiences. Marital difficulty might be seen as a chance to
develop a stronger marriage through greater effort. Death might promote a desire
to live worthy of a reunion with the deceased. Family conflict can indicate the
need to increase family time together and to improve family communication.
The power of prayer and fasting often helps those who are troubled. And many
testify of the comfort they have felt as a group of concerned friends united in
prayer and fasting on their behalf. In some circumstances a special blessing
might be administered to one who is suffering. A message of consolation from the
Lord through those giving blessings often lifts the troubled. Counselors should
seek spiritual guidance in crisis situations and should encourage those they are
helping to seek the power of spiritual resources.
Personal Worth
Unfortunately, many people interpret a crisis as an indication that they lack
personal worth. If they are troubled and overwhelmed, they feel weak,
inadequate, or even worthless. It is important for the troubled person to build
his self-esteem. Questions that provide insight into the person's strengths will
help him do this: Have you made it through difficult periods before? What have
you done in the past to help when things seemed overwhelming What strengths do
you have that might help you solve this problem? As a more balanced picture of
one's power to deal with difficulties emerges from such discussions, the person
will become aware of himself as a resource. This can provide confidence that the
crisis will pass and that he can solve his problems.
The Chinese character for crisis suggests both danger and opportunity. Quite
naturally, in the early stages of crisis, one is most aware of the dangers
involved. But as a person explores his strengths, he becomes more sensitive to
the opportunities that may be present. Enhancing self-worth by overcoming
adversity is one such opportunity. Effective counselors help people see
themselves as part of the solution to the crisis.
The Family
Families are too often deprived of the chance to become closer through
supporting one another during traumatic periods. Counselors can help a person
overcome his pride and fears by exploring the resources of his immediate and
extended family. You might ask: Who do you trust the most in your family? Would
you be willing to let me ask for their help? If they were in a similar
circumstance, would you be eager to help them? Could it be that your pride is
interfering with your willingness to seek their help?
Families can and should offer emotional support during the most trying of
times. For example, a sick child requires help beyond the abilities of the
working parents. The child's aunt is a resource who may come as an "angel
of mercy" to care for the sick child. If a person can't pay a utility bill,
a financially secure cousin might be called upon for help. A family forced to
evacuate their home because of flood danger, might move in with the husband's
sister. Counselors should help people explore all possible family resources that
may help them solve their problems.
The Church
The Church has extensive resources to help with crises. These resources, with
plans for their use, are outlined in various Church handbooks. The resources
include "commodities, fast offering funds, job opportunities, and services
provided by LDS Social Services or Deseret Industries, welfare services
missionaries, welfare service committee members, and Church members with
specific skills and resources." fn After identifying the nature of the
crisis, the counselor may use the appropriate resources available through the
Church to help the troubled person.
The Community
The Church's Welfare Services Resource Handbook notes, "Community
resources that provide services consistent with Church standards may be used.
These include family counseling centers, clinics for the handicapped, private
counselors or therapists, alcohol or drug rehabilitation centers, university
medical centers, mental hospitals, outpatient clinics, and extended care
facilities. State agencies, including agricultural extension services, and
private professional persons, including psychologists, education counselors,
agronomists, accountants, attorneys, and doctors, should be evaluated and
approved by the bishop before their services are used. The bishop should help
members determine how they can receive such assistance without fear of ridicule
or pressure to change values (such as values connected with Church positions on
chastity, abortion, marriage, family prayer, church activity, and the Word of
Wisdom)." fn
Using the Resources Available
Effective counselors will use these resources to help in crisis situations.
The following example illustrates these principles.
The Hill family was in a state of shock when their home teacher arrived at
the hospital emergency room. Annette, their four-year-old and youngest in the
family, had been hit by a car. After being rushed to the hospital, she died.
Several days passed before the shock subsided and the reality hit the family
members. Brother Hill withdrew from contact with almost all his friends. He was
unable to work because of his intense emotions over his daughter's death. He
would often lock himself in his room for long periods of time. The crisis of
Annette's death was now compounded by the reaction of her father.
Through delicate discussions with Brother Hill, his home teacher discovered
Brother Hill's deep feelings of guilt about his daughter's death. The home
teacher determined that the depressed feelings resulted from the idea that in
some way Brother Hill had caused his daughter's death. He reported coming home
later than usual the day of the accident and not spending his accustomed
playtime with Annette. He felt that if he had been home earlier, she would have
come home from her friend's house before the traffic increased and would not
have been hit.
During the next several weeks, the home teacher and Brother Hill talked
almost daily. These discussions revealed that although Brother Hill was
seriously depressed, he was not considering suicide and could begin to examine
the crisis in a broader, more realistic way. The home teacher's goals included
helping Brother Hill through his intense guilt, helping him reestablish contact
with those from whom he was isolated, and helping him develop the emotional
strength to cope with this experience for which he was totally unprepared.
During this period, Brother Hill fasted and prayed often, and this helped him
greatly. Blessing his wife and children gave him renewed contact with his family
and an opportunity to think of the other family members during this crisis that
affected all of them.
Soon he returned to work and was surprised by the concern and support
received from his co-workers. His supervisors, too, seemed to reach out with
understanding toward him.
Brother Hill also took time to study death. He read several books about hew
others have coped with losing loved ones and discovered he was not alone in his
experience. Through study, he also began to develop an eternal perspective about
death, which helped him move from a feeling of hopelessness to one of hope.
Brother Hill learned to understand his guilt feelings and that they would pass.
In this example, the troubled person at first saw the accident as his
responsibility. He withdrew from contact with his family, friends, and others
who might be sources of support. Because of his incorrect ideas and actions, he
increased his stress and the seriousness of the crisis. Later, however, he used
appropriate resources to help him understand the crisis and overcome his
problems. Some of the resources he used were spiritual strength, his family, and
the Church. Counselors should always encourage the troubled people who come to
them to use such resources.
Evaluating Possible Solutions and Their Consequences
After defining the crisis and examining the available resources, the
counselor and the troubled person should examine possible solutions to the
problem. An important part of doing this is considering the possible
consequences of each solution. After they have discussed several solutions, the
counselor and the person should choose the solution that will best solve the
problem and try it to see if it works. It would be wise to seek the Lord's help
in doing this.
As you read the following dialogue, notice how the counselor helps solve the
crisis by (1) helping the troubled person understand it, (2) exploring available
resources, and (3) evaluating possible solutions and their consequences.
Dave:
Mom and Dad don't understand me. They won't even listen. I hate
them!
Counselor: Will you tell me what happened, Dave?
Dave: They say I can't take the car to the dance on Saturday because I
didn't go to church last week. And they say if I don't do better in school, I'll
be grounded for the rest of the term.
Counselor: You seem to think your parents have made some really hard
demands on you.
Dave: Wow, is that an understatement! They're just crazy, and I don't
care if I ever see them again.
Counselor: I guess you'd like to hurt them because they're causing so
much trouble for you.
Dave: That's right, I'd like to tell them what I really think of them.
Counselor: Would that help you feel better about not having the car on
Saturday?
Dave: No, not really, but at least it would let them share some of the
problems they're giving me.
Counselor: This may sound like something your mom and dad would say, but
I hope you'll understand I'm just trying to help you solve this problem. Could
it be they're already hurt because you're not doing as well as they think you
can in school and aren't going to church with them?
Dave: Yeah, I know they don't like what's going on.
Counselor: Why don't we jump in the car and go talk with them about these
problems?
Dave: No thanks. I never want to see them again.
Counselor: Is not seeing them another way to pay them back for what they
have done?
Dave: That's right.
Counselor: Well, how will not seeing them solve the problem about the
car?
Dave: It won't.
Counselor: Maybe since they have control of the car and they are the ones
you are having trouble with, they are the most important resources you have to
solve these problems.
Dave: But how do you talk to someone you hate?
Counselor: Have you hated them in the past?
Dave: Yes.
Counselor: Did you stop after the problem became less serious?
Dave: Yeah, I did.
Counselor: Well, if you stopped hating them over problems in the past,
maybe trying to solve this problem with their help might help you stop hating
them now.
Dave: Maybe, but what about the car for Saturday?
Counselor: Let's go over there and talk with them, and maybe your anger
and having the car can be worked out.
Dave: Okay.
Notice how the counselor in this example helped his friend understand his
problem. Dave realized that his anger was only temporary because of the car,
that he did not really hate his parents. The counselor also suggested an
appropriate resource to help solve the problem: Dave's parents. Finally, the
counselor helped Dave explore possible solutions and their consequences, and
they decided to try one of the solutions.
Suicide
Perhaps the most serious crisis is a potential suicide. Successful prevention
is more likely when a lay counselor recognizes some of the elements of suicide
attempts. Generally, the person contemplating suicide is faced with a problem he
believes is unsolvable and intolerable. His feelings of helplessness and despair
create stress, depression, and withdrawal from all who could give support.
Appetite is frequently depressed, causing a weight loss. Often, the person
doesn't sleep well, and may awake in the middle of the night and be unable to
get back to sleep.
Such symptoms may result from a severe loss of some type, such as a loved
one's death, a broken relationship, unemployment, or a loss of self-esteem.
Counselors who are aware of these situations and symptoms need to become
extremely sensitive to words and actions that may indicate thoughts of suicide.
Such statements as "I don't know how I can go on without her,"
"Things really don't matter anymore," or "Soon everything will be
taken care of, and nobody will have to worry any longer" may suggest a
preparation for suicide. Changing one's will, taking out a large insurance
policy, giving away valued objects, quitting school or a job, or breaking off
contact with friends and relatives may be steps toward suicide.
Suicide attempts are often a cry for help. The victim, feeling unable to cope
with his problems, thinks about suicide, talks about suicide, and attempts
suicide. It is not true that those who talk about taking their lives will
never do it. Such talk may lead to action unless someone intercedes.
The seriousness of the risk can be gauged by the person's circumstances. Does
the person have a gun, lots of sleeping pills, or access to an automobile?
Generally the more specific the threats and the more lethal the method he has in
mind, the greater likelihood of a suicide attempt.
When anyone threatens directly or subtly to take his life, even in jest, you
should start looking for other signs of contemplated suicide.
It is crucial that you contact a professional if it appears there is some
possibility of suicide. It would be far better to contact a professional and
find a suicide threat to be a false alarm than to think you are overreacting to
a threat and delay until it is too late.
The person you think has suicidal feelings needs to know that you care about
him, that you have some ideas about how to help him solve his problems, and that
there is hope for the future. Helping the person plan a better future is one way
to show him that help is available. Moreover, a discussion of alternative future
plans helps him see that things need not be hopeless.
It may be necessary to talk about how suicide would be futile while other
alternatives would not be. Since a person contemplating suicide often thinks
living is futile, you should show him that just the opposite is true. Where
there is life, there is hope, but suicide will only intensify any problems that
already exist. By discussing opportunities available to the person by choosing
to live, and by showing him that he would cheat himself of those
opportunities if he chose to die, you may be able to decrease his desire to die.
Of course, these suggestions assume that the person will talk rationally with
you. Even if the person is not rational or doesn't feel your suggestions are
meaningful, keep talking. To help yourself do this, ask yourself: What does my
love of this person require of me? How can I communicate my concern? Even if his
life seems to mean nothing to him, how can I teach him that his life has meaning
to me?
Summary
